Loretta Keenan

Individual provider Active NPI Registered Nurse · Weaverville, CA

NPI 1841521259 · NPPES record last updated Aug 27, 2015

Key facts

NPI
1841521259
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
267669 (CA)
Practice address
1450 Main Street
Weaverville, CA 96093
Phone
(530) 623-1362
Fax
(530) 623-1447
NPI assigned
Jan 25, 2010
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
30868CAMDChiropractor
267669CAMDRegistered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 30868 CA
Registered Nurse 163W00000X 267669 CA Yes

Addresses

Primary practice location

1450 Main Street
Weaverville, CA 96093

Mailing address

PO Box 1640
Weaverville, CA 96093-1640
Phone (530) 623-1362

Other providers in Weaverville, CA

All providers in Weaverville, CA · Registered Nurse in California

Sources for this page

Verify at the official NPI Registry.